VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 0986221
Sex: F
Age: 27
State: IL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: "Moderna COVID-19 Vaccine EUA" Received second dose at ~3pm on 1/26/21. Symptoms began ~6am on 1/27/21 (~15 hours post vaccination). Symptoms experienced included: significant injection site pain, axillary tenderness, headache, fever, body/flu-like aches, nausea, and significant back pain resulting in missed day of work on 1/27/21. Fever, body/flu-like aches, nausea, and back pain persisted on 1/28/21 resulting in leaving work 3 hours early on 1/28/21. All symptoms were gone by ~5am on 1/29/21 (~47 hours hour post onset of symptoms; ~62 hours post vaccination).

Other Meds: Junel Fe 1/20

Current Illness: n/a

ID: 0986222
Sex: M
Age: 29
State: IN

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: unknown

Allergies: none

Symptoms: called complaining of uncontrollable chills and a fever this morning. He was advised to seek an appointment with his PCP or a walk in facility

Other Meds: none

Current Illness: none

ID: 0986223
Sex: M
Age: 52
State: ME

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: Communicable disease screening

Allergies:

Symptoms: There was no adverse reaction, the patient was exposed to a used needle

Other Meds:

Current Illness:

ID: 0986224
Sex: F
Age: 60
State: NY

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: No tests or labs taken

Allergies: Codeine

Symptoms: After the 1st dose, two days later I had an infected tooth. After 2nd dose of Moderna vaccine, I woke up the 2nd day with my neck lymph glands completely swollen, my jaw hurt really bad, and every tooth in my mouth hurt, and I had another infected tooth on the other side of my mouth. I had to take an antibiotic for both tooth infections. Teeth were not infected prior. By the end of day 2, my lymph nodes were back to normal using Advil for swelling.

Other Meds: Vyvanse - 70 MG XL Emergent C

Current Illness: N/A

ID: 0986225
Sex: F
Age: 52
State: RI

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: Seasonal

Symptoms: Extream fatigue and chills unable to continue work. I am on day 3 now at home coming in and out of sleep and freezing cold. Hoping it won't last much longer.

Other Meds: Maloxacam/ aleeve/vitamin c

Current Illness: N/a

ID: 0986226
Sex: M
Age: 39
State: VA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: EKG; see above

Allergies: FISH PCN

Symptoms: 1/29/2021 1000 10 minutes after Moderna COVID-19 vaccination, resident reports "heart racing" and pruritis. No SOB, no throat complaints, no n/v/d, abd cramping, rhinorrhea, or dizziness. On exam, NAD, lungs CTAB, HR 103, rhythm regular, no murmur; lungs CTAB, no increased WOB. No oropharyngeal edema. No difficulty speaking or swallowing, no hives.O2 sat 97% RA. 1006: Physical exam unchanged, continues to report pruritis. 25 mg benadryl PO given. 1017: physical exam unchanged, reports L side chest burning, 4/10. No other complaints. Escorted to medical for EKG, which is unremarkable and unchanged from prior: SR, rate 90 BPM, nonspec t wave abnormality. QRS 93ms, QTc 414 ms. Symptoms resolved by end of visit in medical clinic. 1325 call to cookchill LPN: resident completely asymptomatic. A/P: abnormal s/s after vaccination,No evidence of anaphylaxis. No rash ever evolved. Pruritis resolved very soon after benadryl administration. report in VAERS.

Other Meds: ACETAMINOPHEN Tablet 650 mg Oral ALBUTEROL 0.083% NEBULIZER Solution 1 AMPULE Inhale ALVESCO 160MCG INHALER 1 PUFFS Oral BIOTENE MOUTH SPRAY Spray 2 SPRAYS Oral busPIRone HCL Tablet 30 mg Oral DEEP SEA NOSE SPRAY Solution 1 SPRAYS NOST

Current Illness:

ID: 0986227
Sex: M
Age: 65
State: FL

Vax Date: 01/13/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: COVID 19 test

Allergies:

Symptoms: I had COVID test 2 months ago and was negative and I went two times and both negative. Then I got the vaccine 3 weeks ago. Today I tested positive for COVID19 and believe the vaccine caused me to be positive. Asymptomatic as of now. Wants the public to be made aware that you may test positive for COVID after receiving the vaccine.

Other Meds: Zinc, Vitamin D, Vitamin C, B6,

Current Illness:

ID: 0986228
Sex: F
Age: 57
State:

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Heart racing, blotchy face lumpy throat, itchy head. Gave benadryl po. Patient improved.

Other Meds:

Current Illness:

ID: 0986229
Sex: F
Age: 43
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: taste/smell alteration within 1 hour of vaccine / facial twitching 3 days later / CNS depression

Other Meds:

Current Illness:

ID: 0986230
Sex: M
Age: 69
State: TX

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: penicillin

Symptoms: Just had a low grade fever of about 99.2. Took some tylenol and it is gone

Other Meds: none

Current Illness:

ID: 0986231
Sex: F
Age: 22
State: AZ

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rash at injection site one week after vaccination. Cold and flu like symptoms 15-20 hours after injection.

Other Meds:

Current Illness:

ID: 0986232
Sex: F
Age: 51
State: LA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: At 4:45 am on 1/28/2021, woke up having body aches, and headache. At 3:30pm, began having chills. At 6pm, had 101.9 fever. Continued to have body aches and chills. Took tylenol. Fever broke around 9pm. Body aches contininued until next morning . Felt back to normal on 1/29/2021 around noon.

Other Meds: None

Current Illness: None

ID: 0986233
Sex: F
Age: 80
State: FL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: N/A

Allergies: Zithromax, Penicillins, Sulfa Antibiotics

Symptoms: Resident s/p Covid 19 Vaccination on 01/19/21.. Resident stated she got 3 small raised areas (2.0L X 2.0W cm) (1.5L X 1.5W cm) (1.0L X 1.0W cm) on Right lower leg and one small raised area (1.0L X 1.0W cm) on left lower leg. She noticed them the next day after the vaccination (1/20/21). Besides, She also noted raised, red, area on the injection site on her right upper arm on 01/27/21. She also stated that she had bad reaction, dry heaving after she had her Flu and Pneumonia vaccine last year. Denied shortness of breath, difficulty breathing, fever, tender, pain upon touch but very itchy and asking any medication. Wellness Nurse explained resident to keep the area clean and dry, no scratching and to let us know if there is increased redness/ area or skin breakdown.

Other Meds: Metoprolol Tartrate Tablet 25 MG, Levothyroxine Sodium Tablet 75 MCG, cloNIDine HCl Tablet 0.1 MG, PreserVision AREDS Capsule (Multiple Vitamins-Minerals), Multiple Vitamins-Minerals Tablet, Melatonin Tablet 5 MG, Biotin Capsule, Travopr

Current Illness:

ID: 0986234
Sex: M
Age: 38
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: couldn't move left arm above head initally. Dizzy, pale, tired, chills, aches, nausea then vomiting fever 102.

Other Meds:

Current Illness:

ID: 0986235
Sex: F
Age: 32
State: NY

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: shellfish

Symptoms: Patient reports subjective fevers, nausea, bodyaches, and multiple episodes of diarrhea 12 hrs after receiving vaccine.

Other Meds:

Current Illness:

ID: 0986236
Sex: M
Age: 26
State: AZ

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: Shrimp

Symptoms: High grade fever (104.5) F Tylenol No change

Other Meds: N/a

Current Illness: N/a

ID: 0986237
Sex: F
Age: 26
State: KS

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: Dogs, Cats

Symptoms: Slight swelling of tongue (sensation that tongue is suddenly too big for mouth) about 20 minutes following the shot and continuing over the next 22 hours and currently.

Other Meds: Prozac, Adderal, flonase anti-histamine, EPA-DHA, vitamin C supplement, hydroxyzine (used night before).

Current Illness: None

ID: 0986238
Sex: F
Age: 70
State: MI

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: Chills Low grade temp 99.2 - Took Tylenols Mild body ache Sleepy Injection site tenderness All symptoms disappeared next morning, except for arm tenderness.

Other Meds: Metoprolol Vit D Zinc Fish Oil Caps

Current Illness: Hypertension

ID: 0986239
Sex: F
Age: 80
State: CA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None.

Allergies: Levaquin (leg cramping, nausea, diarrhea).

Symptoms: Starting on 1/22/21 her arm started to itch, got red circle around injection site about a quarter size, warm and hard in that area. On 1/23/21, started to put warm compresses x 3, Sunday the same thing and by Monday it had dissipated and was fine. Then last night 1/29/21, about 1:30 AM got up as she was not sleeping well, took two Aleve. Woke up this morning with arm itching, red again and kind of warm. Feels fine but that location has reappeared from the initial injection. Pink in color and warm to touch.

Other Meds: Atenolol, Synthroid, Rosuvastatin, baby aspirin, Niacin, vaginal cream Estrace. Citracel, vitamin C, Super B complex, mature multivitamin, fish oil, Quinol Omega C0Q 10

Current Illness: None.

ID: 0986240
Sex: F
Age: 48
State:

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever, body aches. called in sick to work.

Other Meds:

Current Illness:

ID: 0986241
Sex: F
Age: 69
State: TX

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: Adhesives, Atorvastatin (leg cramps), Budesoide+Formoterol

Symptoms: COVID- 19 Vaccine Patient used own Epi-pen after vaccine due to sensation of throat tightness and shortness of breath. Symptoms had resolved completely prior to presenting to emergency department. Patient treated with diphenhydramine 50 mg oral, dexamethasone 6 mg oral, and famotidine 40 mg oral. Discharged home with complete resolution of symptoms after two hours of observation.

Other Meds: Alprazolam 0.5 mg nightly prn, Aspirin 81 mg daily, (Cont.)

Current Illness:

ID: 0986242
Sex: F
Age: 51
State:

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt is a 51yo otherwise healthy F with no cardiac or anaphylactic/allergic reaction hx presenting with concern for reaction from Moderna vaccination. Pt had vaccination at 11:40am. At 12:15n, pt returned to the clinic after leaving with CC of "lump in throat" She describes lump in throat, dizzy and feeling as though her symptoms are becoming worse. Her VS were obtained: 155/87, 98%, HR 81 Rechecked at 12:26p - pt describes worsening symptoms 12:27p - lying down, pt feels improved, sitting upright, her symptoms returned 12:29 - pt was given 50mg PO Benadryl and 0.3 epinephrine. Pt feels slightly tachy, but overall, feeling improved. 12:40p continues to have heart racing, moderate in severity. VS obtained: 118/77, 98%, HR 106 Pt transported to the ED by EMS at 12:45p. Pt feels improved. Ambulating well. No additional symptoms.

Other Meds:

Current Illness:

ID: 0986243
Sex: F
Age: 32
State: AR

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: N/A

Allergies: NKDA

Symptoms: Vaccine given in tricep instead of deltoid (believe to have been 1 inch needle). Normal redness, localized tenderness.

Other Meds: Adderall 20mg

Current Illness: N/A

ID: 0986244
Sex: F
Age: 95
State: VA

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: Sulfa antibiotics

Symptoms: Patient did not have any issues until 1/29/21 at around 8:40 AM (the day after vaccination). Her symptoms are: Pale, lethargic, hypotension, slurred speech, unable to verbalize, and weak. Her blood pressure was found to be 68/34. Pulse was 66, O2 93, and temperature was 98.6 degrees F. EMT was called and the resident was sent out. Hospital has been called and they are unknown what is going on and unsure if the resident will be admitted or not.

Other Meds:

Current Illness:

ID: 0986245
Sex: M
Age: 70
State: FL

Vax Date: 01/09/2021
Onset Date: 01/16/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: XRAY, CAT SCAN, Blood work

Allergies: none

Symptoms: pt started having abdominal pains a day or two after vax. Pt visited his PCP on 1/12/201 which ordered X-ray and Cat scan, blood work which came back normal. On 1/16/2021 pt was having more abdominal pain so went to the ER where they did another Cat scan which was also normal so he was given a pain pill and sent home. When pt got home from ER a rash had developed on right side of torso. Pt saw his PCP on 1/18/2021 for the rash and was diagnosed w/ Shingles. Rash is still visible but fading.

Other Meds: Synthroid, Lexapro, Alfuzosin, Lipitor, Eliquis, vitamin D3, Fish Oil, multivitamin

Current Illness: none

ID: 0986246
Sex: F
Age: 30
State: WA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: I received the second dose around 1:39-1:40pm and II didn't feel anything until 2-3am the next day. I felt chills, shivers, headache, body aches, I felt slow. I would feel cold and then warm and then cold again. I was sweating a lot and I currently still have a dull headache 2 days later.

Other Meds: Vitafusion Women's Multivitamin Gummies

Current Illness: none

ID: 0986247
Sex: F
Age: 53
State: VA

Vax Date: 01/05/2021
Onset Date: 01/01/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: dust mites, tree pollen, grass pollen, mold

Symptoms: Shingles- developed on 1/2/2021. I did not know that I had the shingles when I took the vaccine on 1/5/2021. I have never had the shingles, I thought it was a rash. I have allergies, have been known to develop dermatitis occasionally. Diagnosed with shingles by my primary care provider on 1/6/2021. Also went to Ophthalmologist as a precaution since the area around my left eye was affected. Primary care doc prescribed Valtrex (7 day regimen). As of today 1/29, I have residual nerve itching, skin is healed. Some nerve pain.

Other Meds: Azelastaine spray, Tylenol, Zyrtec, Singulair

Current Illness: Shingles- developed on 1/2/2021. I did not know that I had the shingles when I took the vaccine on 1/5/2021. I have never had the shingles, I thought it was a rash. I have allergies, have been known to develop dermatitis occasionally. Diagnosed with shingles by my primary care provider on 1/6/2021. Also went to Ophthalmologist as a precaution since the area around my left eye was affected.

ID: 0986248
Sex: F
Age: 30
State: KS

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: N/A

Allergies: Keflex and sulfa

Symptoms: Red, swollen injection site Welt two-three inches below site; not connected directly to site Fever of 101 Aches Chills Difficulty breathing- needed rescue inhaler Fatigue

Other Meds: Nuva-ring Loratidine Effexor XR Propanolol Diclofenac Sodium

Current Illness: COVID-19 three weeks prior

ID: 0986249
Sex: M
Age: 60
State: MA

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Pink itchy rash on torso, arms , elbow and knee creases consistent with a drug rash.

Other Meds: Bupropion XL 300 mg

Current Illness: None

ID: 0986250
Sex: F
Age: 42
State:

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever. called in sick to work.

Other Meds:

Current Illness:

ID: 0986251
Sex: F
Age: 33
State: NM

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: First Tingling in lips. Then entire face started to tingle. This has not subsided.

Other Meds: Sertraline

Current Illness:

ID: 0986252
Sex: F
Age: 47
State: NY

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: First dose given 12/24/2020 injection site pain developed 12 hours after vaccine given and resolved by 24 hours post vaccination. Trunk rash developed 48 hours after vaccine and resolved within hours. Twelve hours after second dose on 1/14/2021, developed chills, aches, burning neuropathic pain all over, temperature of 101 degrees F. After 5 hours took 600 mg ibuprofen with relief and required another dose at noon the day after vaccination. Symptoms resolved within 24 hours. Developed pruritic trunk rash that lessened within hours but took > 2 weeks to resolve.

Other Meds: multivitamin

Current Illness: none

ID: 0986253
Sex: F
Age: 50
State: IN

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Starting one day after the vaccine, I developed a headache which turned into a migraine within 24 hours. The migraine became debilitating on Sunday, January 3, 2021. I had vomiting, nausea and dizziness as well. I was unable to work on Monday, January 4, 2021 because I still had the migraine. I take Ubrelvy (prn) and it did not work. I attempted to return to work Tuesday afternoon as the migraine subsided, but it returned shortly after I made it to work. Our treatment nurse took my blood pressure, it was high. My blood sugar was high. I was dehydrated and the migraine was back. My nurse practitioner treated me with an IV of saline solution, pain relieving injection for the migraine and Zofran for the nausea.

Other Meds: Metformin, Paxil, Amaryl, Topamax, Effexor, Singulair, Omeprizol, Simvastatin, Losartin, Humalog, Basaglar

Current Illness:

ID: 0986254
Sex: U
Age:
State: OR

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Paient was treated by healthcare providers for shingles, and other zoster-related conditions.; Patient was treated by healthcare providers for shingles, and other zoster-related conditions; Information was received from a lawyer regarding a case in litigation concerning a patient (pt) of unknown age and gender. The pt's medical history, concurrent conditions, or concomitant medication were not provided. In 2014, the pt was inoculated with zoster vaccine live (ZOSTAVAX) (dose, frequency, route of administration, anatomical location, lot number and expiration date were not provided) by a helthcare professional for the long term prevention of shingles and zoster-related conditions. Subsequent to pt's zoster vaccine live (ZOSTAVAX) inoculation, ptwas treated by healthcare for shingles, and other zoster-related conditions. As a direct and proximate result of pt's use of the zoster vaccine live (ZOSTAVAX) vaccine, pt had and would continue suffer ongoing injuries, including but not limited to: mental and physical pain and suffering; medical care and treatment for these injuries; significant medical and related expenses as a result of these injuries, including but not limited to medical losses and costs include care for hospitalization, physician care, monitoring, treatment, medications, and supplies; diminished capacity for the enjoyment of life; diminished quality of life; increased risk of premature death, aggravation of preexisting conditions and activation of latent conditions; and other losses and damages; and would continue to suffer such losses, and damages in the future. The outcome of the events was not reported. The events were reported to be related to zoster vaccine live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 0986255
Sex: F
Age: 40
State: PA

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: N/a

Allergies: Lidocaine, penicillin, tetracycline, egg and chicken

Symptoms: Large 3 inch circle around injection site, swollen, warm, itchy and lasted 3 days after injection then returned on day 7 after injection and was 4 inches wide on arm.

Other Meds: Gabapentin, clonazepam, tizanidine, duloxetine, lexapro, aimovig 140, compazine, meclizine, rx vitamin D, amitriptyline, rizatriptan, levothyroxine, fish oil, omega 3, multivitamin, fiber, magnesium, b12

Current Illness: Sciatica flare up,

ID: 0986256
Sex: U
Age:
State: OH

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Plaintiff was treated by healthcare providers for shingles, and other zoster-related conditions.; Plaintiff was treated by healthcare providers for shingles, and other zoster-related conditions.; Information was received from a lawyer regarding a case in litigation concerning a patient (pt) of unknown age and gender. The pt's medical history, concurrent conditions, or concomitant medication were not provided. In 2015, the pt was inoculated with zoster vaccine live (ZOSTAVAX) (dose, frequency, route of administration, anatomical location, lot number and expiration date were not provided) by a helthcare professional for the long term prevention of shingles and zoster-related conditions. Subsequent to pt's zoster vaccine live (ZOSTAVAX) inoculation, pt was treated by healthcare for shingles, and other zoster-related conditions. As a direct and proximate result of pt's use of the zoster vaccine live (ZOSTAVAX) vaccine, pt had and would continue suffer ongoing injuries, including but not limited to: mental and physical pain and suffering; medical care and treatment for these injuries; significant medical and related expenses as a result of these injuries, including but not limited to medical losses and costs include care for hospitalization, physician care, monitoring, treatment, medications, and supplies; diminished capacity for the enjoyment of life; diminished quality of life; increased risk of premature death, aggravation of preexisting conditions and activation of latent conditions; and other losses and damages; and would continue to suffer such losses, and damages in the future. The outcome of the events was not reported. The events were reported to be related to zoster vaccine live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 0986257
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Son who is 16 received the Moderna vaccine by mistake; A spontaneous report was received from a HCP concerning his 16-year old, son who received Moderna's COVID-19 vaccine (mRNA-1273) resulting in the event, my son who is 16 received the Moderna vaccine by mistake. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first dose of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the 16-year old received the mRNA-1273 vaccine. No treatment for the event was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, 16-year old received vaccine was considered Resolved.; Reporter's Comments: This report refers to a case of product administered to patient of inappropriate age for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 0986258
Sex: U
Age:
State: VA

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A 17 year old was given the moderna vaccine; A spontaneous report was received from a physician concerning a 17-year-old patient who received Moderna's Covid-19 vaccine (mRNA-1273). The patient's medical history was not provided. Concomitant product use was not provided. On an unknown date, the patient received their first of two planned doses of mRNA-1273 (Lot number: not provided) for prophylaxis of COVID-19 infection. On an unknown date, 17-year-old was given the Moderna COVID-19 vaccine. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not provided. The event, a 17-year-old was given the Moderna vaccine, was considered resolved.; Reporter's Comments: This case concerns a 17-year-old patient who received the first of two planned doses of mRNA-1273 (Lot unknown), reporting product administered to patient of inappropriate age and at this time no adverse events were reported.

Other Meds:

Current Illness:

ID: 0986259
Sex: F
Age: 35
State: IA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: unknown... possible MRI at emergency department

Allergies: NONE LISTED

Symptoms: Patient felt light headed within 5 minutes of having Modera Covid-19 vaccination. Consumer then became unresponsive after receiving vaccination. He was breathing and had a pulse. . It looked like he was having a seizure; his eyes rolled upward, his left arm shook and he did not respond to touch or voice. . 911 was immediately called and responded within a couple minutes. After a minute he came to and still felt very lightheaded Upon arrival of 911 his BP and heart rate were extremely low and he was profusely sweating. He was then taken to the emergency department.

Other Meds: LISINOPRIL/HCTZ

Current Illness: NONE LISTED

ID: 0986260
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: This is a spontaneous report from a non-contactable consumer communicated to a Pfizer colleague. A patient of unspecified age and gender received bnt162b2 (COVID-19 VACCINE, lot number and expiration date not reported), via an unspecified route of administration from an unspecified date at a single dose for Covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced sore injection site on an unspecified date. Outcome of the event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 0986262
Sex: F
Age: 49
State: NY

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 12/24 felt horrible, experienced body aches, chills, dizziness, nausea, night sweats , possible fever , did not check, soreness at injection site. 12/25 felt the same until 12/27

Other Meds:

Current Illness:

ID: 0986263
Sex: F
Age:
State: CA

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: This is a spontaneous report from a contactable nurse, reporting for herself. A 59-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), first dose on 23Dec2020 11:45 (lot number: EL0140) and second dose on 10Jan2021 10:15 (lot number and expiry date were not reported), both intramuscularly in the left arm at a single dose for COVID-19 immunization. Vaccination was done in a hospital. Medical history included occasional gastrooesophageal reflux disease (GERD), osteoarthritis, penicillin allergy and sulfa allergy, all from an unknown date and unknown if ongoing; and shingles from Mar2018 to an unknown date. Concomitant medication included paracetamol (TYLENOL), famotidine (PEPCID), melatonin and colecalciferol (VITAMIN D). The patient previously took vicodin and experienced allergies. It was reported that after both injections, the patient had a headache in the same area where shingles had started in Mar2018 throbbing above left eye radiating to top of head on 23Dec2020 14:30. No treatment was given. There was no other vaccine in four weeks. There was no Covid prior vaccination. No Covid tested post vaccination. The patient was not pregnant. The patient recovered with lasting effects. Information on the batch/lot number has been requested.

Other Meds: TYLENOL; PEPCID [FAMOTIDINE]; MELATONIN; VITAMIN D [COLECALCIFEROL]

Current Illness:

ID: 0986264
Sex: F
Age:
State: NC

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: This is a spontaneous report from a contactable nurse (patient). A 58-year-old female patient received second single dose of BNT162B2 (Pfizer, batch/lot number and exp date not reported), intramuscular (vaccine location: Left arm) on 12Jan2021 11:00 for COVID-19 immunization. Facility type vaccine: Hospital. Medical history included allergies to penicillin. There were no other medical history. The patient was not pregnant. The patient did not have COVID prior vaccination. Other medications in two weeks include escitalopram oxalate (LEXAPRO) and meloxicam. There were no other vaccines in four weeks. The patient was previously given first single dose of BNT162B2 on 24Dec2020 10:30, Intramuscular (Right arm) for COVID-19 immunization. The patient previously took tetracycline and experienced allergies. The patient experienced severe joint pain in bilateral knees on 12Jan2021 22:00, and was still present 3 days post 2nd injection. No treatment was given for the event. The patient was not COVID tested post vaccination. The outcome of the event was not recovered. Information about lot/batch number has been requested.

Other Meds: LEXAPRO; MELOXICAM

Current Illness:

ID: 0986265
Sex: F
Age: 56
State:

Vax Date: 12/30/2020
Onset Date: 01/12/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rash and itching.

Other Meds:

Current Illness:

ID: 0986266
Sex: M
Age:
State:

Vax Date: 01/12/2021
Onset Date: 01/01/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: all around his eye- swollen puffy and corner is very red ("like a bruise"); all around his eye- swollen puffy and corner is very red ("like a bruise"); This is a spontaneous report from a contactable consumer (patient's spouse). A male patient of an unspecified age (reported as "85", unknown unit) received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiry date: unknown), via an unspecified route of administration from 12Jan2021 at a single dose for COVID-19 immunization. The patient medical history was not reported. The patient experienced all around his eye- swollen puffy and corner is very red ("like a bruise") on an unspecified date in Jan2021. Outcome of the events was unknown. Patient was taking a blood-thinner and reporter was asking if it was causing the event. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0986267
Sex: F
Age:
State:

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: her throat would be sore; tongue started tingling; stinging in her tongue, like she had burned it; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age (age 75; unit: unknown) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number EL3248), via an unspecified route of administration on 11Jan2021 at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient received the first dose on Monday 11Jan2021, and her tongue started tingling the next day (12Jan2021) and was continuing at the time of report. On Tuesday (12Jan2021), she started stinging in her tongue, like she had burned it. She can eat and swallow, it's just that her tongue was stinging. And sometimes her throat would be sore but it's still here. The patient was wondering if the side effect last that long or there may be some more concern. Outcome of the events was not recovered.

Other Meds:

Current Illness:

ID: 0986268
Sex: M
Age:
State: UT

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: Test Name: Blood samples; Result Unstructured Data: Test Result:unknown results; Test Name: EKG; Result Unstructured Data: Test Result:unknown results; Test Date: 20210115; Test Name: Chest pain; Result Unstructured Data: Test Result:pain scale 5/10; Test Name: XR Chest; Result Unstructured Data: Test Result:unknown results

Allergies:

Symptoms: Chest Pain - All across the upper chest - pain scale 5/10; This is a spontaneous report from a contactable consumer (patient). A 71-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date not reported), via an unspecified route of administration on 14Jan2021 11:00 at a single dose for COVID-19 immunization. Medical history included COVID-19 in Feb to Mar2020 (patient could have had COVID-19, No COVID tests were available). The patient's concomitant medications were not reported. The patient experienced chest pain - all across the upper chest - pain scale 5/10 - no other symptoms on 15Jan2021 11:15. The event resulted in emergency room/department or urgent care. The patient was given aspirin 325 mg as treatment. The patient also underwent lab test which includes EKG, XR Chest, two blood samples on an unspecified date. The outcome of the event was recovered on an unspecified date. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0986269
Sex: F
Age: 80
State: MI

Vax Date: 01/23/2021
Onset Date: 01/25/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None

Allergies: I have IBS-C and cannot eat fresh fruits, milk products, most raw vegetables, anything with non natural additives, added products for shelf life or consistency. I have to carefully read all the ingredients in a product before I purchase it.

Symptoms: I had terrible bloating and gas January 22, all day diarrhea January 25 and gas all this week which is only helped by heating pad on stomach and when ready to exit standing to release gas from bowels, plus have had to take the simethicone 6 to 7 times per day.

Other Meds: Librax, venllafaxine, Latanoprost, prilosec, simethicone, multivitamin, probiotic, culturele, gamma E complex. vitamin C, vitamin D3, zinc balance, evening primrose oil, calcium citrate, glucosamine sulfate, omega 3 fish oil and tylonel

Current Illness: Not considered illness perhaps, but have bad arthritis (have had both hips replaced) and scoliosis for lifetime

ID: 0986270
Sex: M
Age:
State: CT

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: This is a spontaneous report from a non-contactable consumer. A male patient of an unspecified age received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient's medical history was not reported. There were no concomitant medications. The patient reported he takes a blood thinner. Received 1st dose of vaccine and "look like blood when I was spitting/hacking up last night, this morning no blood." The outcome of the event was unknown. No follow-up attempts are possible. Information on lot/batch cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 0986271
Sex: F
Age:
State: MA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: This is a spontaneous report from a contactable physician. A 44-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection; lot number: EL1284), via an unspecified route of administration on 08Jan2021 08:00 at SINGLE DOSE at left arm for COVID-19 immunization. The patient's medical history was not reported. The patient is not pregnant. There were no concomitant medications. The patient received first dose of BNT162B2 on 18Dec2020 08:00 AM at left arm lot number= EJ1685. On 09Jan2021 11:00, the patient experienced right tinnitus. The patient did not receive treatment for the event. The outcome of the event was not recovered.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm